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People who self‐injure present a serious concern for many healthcare providers and no more so than for those working in the female prison estate. Despite the prevalence of self‐injury and recent policy highlighting the need for staff training, misunderstanding and misinterpretation of self‐injury is rife within the healthcare professions often demonstrated by poor levels of service and care. This paper seeks to describe the development of a self‐injury training package for prison staff, through service user involvement, in order to address such deficits in care.

A participatory mixed methodological design engaged both staff and women in prison. Women offenders were involved in the development of training drawing upon their unique experiential expertise.

In total, 43 per cent of staff working directly with women recognised the need to develop their understanding of, and skills to manage, self‐injury. Key messages women wanted to convey to staff included how to communicate effectively and demonstrate empathy.

Service user involvement in the training of staff is achievable in a prison environment. Women and prison staff identify the need for on‐going training in relation to the management of self‐injury. Limitations of the sampling strategies are acknowledged but not considered significant.

The authors assert that service user involvement is crucial in the development of meaningful training in the management of self‐injury.

The involvement of service users in prison staff training empowers those involved and may foster improved prisoner‐staff relationships.

Service user involvement in prison staff training has no precedent in the UK.

Non-suicidal self-injury (NSSI) is distinguishable from suicide attempts (SAs) on a number of psychological and motivational factors. However, in corrective services settings, NSSI and SA are not clearly distinguished in assessment impacting on intervention. The purpose of this paper is to examine if any attributes differentiate lifetime history of SA+NSSI, NSSI and SA presentations in inmates who had recently been assessed in custody by a risk intervention team.

A comprehensive clinical assessment and file review was conducted with 87 male inmates (including a no self-injury control group) in two large correctional centres in New South Wales, Australia, to determine if three self-injury groups differ from the control group and if the three self-injury groups differ from each other across a range of static, trait, environmental and clinical characteristics.

The SA+NSSI group was most different from the control group (27/59 variables), and from the SA group (10/59 variables), predominantly across trait and clinical correlates. The SA group was least different from the control group (2/59 variables: suicide ideation, childhood physical abuse).

It was found that the presence of SA+NSSI history is an indicator of increased psychopathology. A history of SA only appears not readily associated with psychopathology. The self-injury subgroups reflected different clinical profiles with implications for risk assessment and treatment planning.

The purpose of this paper is to explore client‐reported functions of deliberate self‐injury for prisoners located within a dangerous and severe personality disorder site.

As interviews produced in‐depth data indicating a very idiosyncratic experience of the function of deliberate self‐injury, interpretative phenomenological analysis was used within a small‐scale case study design.

Identified functions mirrored current quantitative research but few emerging themes were identified across the sample. Participants presented with varying levels of insight into their deliberate self‐injury.

A small sample of young males was used within the study.

A “status‐seeking” function of deliberate self‐injury was also observed, which is not explicitly discussed within the current literature base. This study's findings can be of use to treatment providers for this population given their complex responsivity needs.

This paper reports findings from a study of the social, situational and environmental factors that contribute to suicide and self‐injury in prison, focusing here on prisoners' motivations for their actions. In‐depth interviews were conducted with 143 prisoners in ten prisons in England and Wales who had engaged in an act of self‐injury or an attempt at suicide. The majority of participants described a number of precipitating or motivational factors related to concrete events, feelings/emotions (or both), operating within five different dimensions: offence‐related, interpersonal, symptom relief, instrumental and situational. In very few cases were there single reported causes. Motivational factors more prevalent among participants who attempted suicide included relationship problems, concerns about forthcoming court appearances and factors relating to drug withdrawal. Those who attempted suicide were more likely to describe concrete events or experiences as motivational factors. Those who injured themselves without suicidal intent were much more likely to describe negative feelings or emotions as precipitating factors. The results highlight the complex and multifactoral nature of suicidal and self‐injurious behaviours. At the very least they lend support to the suggestion that different strategies should be developed for those who attempt suicide and those who injure themselves for other reasons.

Patients in the National High Secure Healthcare Service for Women have a high prevalence of trauma and self injury. This highlights the need for specialised training of staff dealing with such women. The aim of this study was to evaluate the trauma and self injury (TASI) training programme on staff knowledge and skills.

A total of 135 nurses and nursing assistants participated in the TASI two‐day training course. Questionnaires allowing for quantitative and qualitative data collection were completed before and after the training. Training and confidence levels in dealing with women who self‐harm prior to the training were identified and the impact of the programme was assessed.

The majority of staff had not received any previous training on trauma and self injury. There was an increased level of confidence in working with trauma and self injury following training and staff reported an increased ability to ask for support. Self‐perceived competence improved to a greater extent in those who had not received previous training compared to those who had.

The authors' data is limited to self‐report. Future research should use objective measures to evaluate the impact of staff training.

A relatively short training programme focusing on trauma and self injury appears to improve staff confidence, understanding and competence in working with women patients in a high secure setting. Similar training programmes might also be beneficial in different patient groups with complex backgrounds and behaviours.

This is the first report on a training programme focussing on women in high secure care who self‐harm and have experienced trauma.

Self‐injurious behaviour can become an intransigent difficulty, reduce people's quality of life and lead to hospital admissions or other restrictive outcomes (such as the wearing of protective devices to prevent serious injury). Over the last 15 years there have been some important developments in the treatment of severe self‐injury, but the evidence is that these are making little impact on most people's lives. The reasons why this might be are discussed, and it is proposed that it is time for a radical new approach to interventions for self‐injurious behaviour.

This article reports on support that people with learning disabilities who self‐injure say they have found, or would find, helpful in relation to their self‐injury. It is an important issue, because most interventions and approaches are based on past patterns of support or what professionals think is helpful or appropriate. Rarely has the voice of the person concerned been heard. The clear message from people with learning disabilities, including those who use little or no verbal communication, is that they want opportunities to communicate their feelings and to be listened to. Being open to listening and developing one's own communication skills is essential for supporters of people with learning disabilities who self‐injure.

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT).

Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a) method. In total, 18 one hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation.

The level of urge for each trigger was reduced to 0 which the patient defined as “no urge to self-injure”. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks.

This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure.

The case report offers an important contribution to an area that requires much further research.

The purpose of this paper is to call on researchers and clinicians to carefully consider the terminology used when discussing non-suicidal self-injury (NSSI), and specifically the use of the term “maladaptive” coping.

Drawing on literature regarding stigma, language and self-injury to support the argument that the term maladaptive is inappropriate to describe self-injury.

Use of the term maladaptive conflates short-term effectiveness with long-term outcomes and ignores context in which the behaviour occurs.

Use of the term maladaptive to describe self-injury can invalidate the person with a history of NSSI, impacting stigma and potentially help-seeking. An alternate framing focussed on specific coping strategies is offered.

Language is a powerful medium of communication that has significant influence in how society shapes ideas around mental health. In proposing a change in the way the authors’ talk about self-injury there is potential to significantly improve the wellbeing of people with lived experience of self-injury.

The purpose of this paper is to critically evaluate the current evidence for peer support in prisons, in particular its contribution to working with prisoners who self-injure and the extent to which the success of peer support schemes such as the prison listeners, hinges upon staff’s willingness to engage with the initiative.

The review was constructed by using primary and secondary terms to search the literature. The studies focused on peer support in custody with reference to mental health and self-injury. Searches identified papers on the prison listener scheme and staff perspectives on prison peer support, as these formed a central focus of the review. Studies were excluded from the review if the participants’ behaviours was explicitly linked to suicidal intent, as the review focused on self-injury as a coping strategy.

A total of 23 studies were selected according to specific inclusion criteria (six were grey literature, 17 academic literature). Of the 23 studies ten studies focused on peer support and self-injury. Of the 23 studies the listener scheme was the focus of 15 studies, of these 15 studies self-injury and the listener scheme was a focus of eight studies.

Evidence from the review suggests that prison peer support could be considered on a continuum depending on the different degrees of peer involvement.